Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
5503POP	CARBOMER-980 carbomer-980 0.2% eye gel, 10 g (PI, CMI)	1	1	5	$16.52	$17.92	$21.37
	Available brands
	Optifresh eye gela
	PAAa
	Viscotearsa * Additional charge for this brand is $3.67B	1	1	5	$20.19	$17.92	$25.04

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
5504QOP	CARBOMER-980 carbomer-980 0.2% eye drops, 30 x 600 mg ampoules (PI, CMI)	3	3	5	$30.66	$31.60	$31.60
	Available brands
	Viscotears Gel PF

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
8384GMPNP	CARBOMER-980 carbomer-980 0.2% eye gel, 10 g (PI, CMI)	1	1	5	$16.52	$17.92	$21.37
	Available brands
	Optifresh eye gela
	PAAa
	Viscotearsa * Additional charge for this brand is $3.67B	1	1	5	$20.19	$17.92	$25.04

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
8578LMPNP	CARBOMER-980 carbomer-980 0.2% eye drops, 30 x 600 mg ampoules (PI, CMI)	3	3	5	$30.66	$31.60	$31.60
	Available brands
	Viscotears Gel PF

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9210RMP	CARBOMER-980 carbomer-980 0.2% eye gel, 10 g (PI, CMI)	1	1	11	$16.52	$17.92	$21.37
	Available brands
	Optifresh eye gela
	PAAa
	Viscotearsa * Additional charge for this brand is $3.67B	1	1	11	$20.19	$17.92	$25.04